A Shocking Diagnosis: Breast Implants ‘Gave Me Cancer’

Raylene Hollrah was 33, with a young daughter, when she learned she had breast cancer. She made a difficult decision, one she hoped would save her life: She had her breasts removed, underwent grueling chemotherapy and then had reconstructive surgery.

In 2013, six years after her first diagnosis, cancer struck again — not breast cancer, but a rare malignancy of the immune system — caused by the implants used to rebuild her chest. “My whole world came crumbling down again,” said Ms. Hollrah, now 43, who owns an insurance agency in Hermann, Mo. “I had spent the past six years going to the oncologist every three months trying to keep cancer away, and here was something I had put in my body to try to help me feel more like a woman, and it gave me cancer. I thought, ‘I’m not going to see my kids grow up.’”

Her disease — breast implant-associated anaplastic large-cell lymphoma — is a mysterious cancer that has affected a tiny proportion of the more than 10 million women worldwide who have received implants. Nearly all the cases have been linked to implants with a textured or slightly roughened surface, rather than a smooth covering. Texturing may cause inflammation that leads to cancer. If detected early, the lymphoma is often curable.

The Food and Drug Administration first reported a link between implants and the disease in 2011, and information was added to the products’ labeling. But the added warnings are deeply embedded in a dense list of complications, and no implants have been recalled. The F.D.A. advises women only “to follow their doctor’s recommended actions for monitoring their breast implants,” a spokeswoman said in an email this month. Until recently, many doctors had never heard of the disease, and little was known about the women who suddenly received the shocking diagnosis of cancer brought on by implants. An F.D.A. update in March that linked nine deaths to the implants has helped raise awareness. The agency had received 359 reports of implant-associated lymphoma from around the world, although the actual tally of cases is unknown because the F.D.A.’s monitoring system relies on voluntary reports from doctors or patients.

The number is expected to rise as more doctors and pathologists recognize the connection between the implants and the disease. Women who have had the lymphoma say that the attention is long overdue, that too few women have been informed of the risk and that those with symptoms often face delays and mistakes in diagnosis, and difficulties in receiving proper care. Some have become severely ill. Implants have become increasingly popular. From 2000 to 2016, the number of breast augmentations in the United States rose 37 percent, and reconstructions after mastectomy rose 39 percent. Annually, nearly 400,000 women in the United States get breast implants, about 300,000 for cosmetic enlargement and about 100,000 for reconstruction after cancer, according to the American Society of Plastic Surgeons. Allergan and Mentor are the major manufacturers. Worldwide, an estimated 1.4 million women got implants in 2015.

Read more from the New York Times here.

8 Tips For Choosing The Best Bra Following A Mastectomy

Here are some helpful tips in choosing the best bra after undergoing a mastectomy:

1. Wide, comfortable and adjustable straps are crucial for reducing the risk of Lymphedema developments.


2.  Good separation between the cups, with a deeper centre that sits against the breastbone will ensure the breast form is secured firmly and cannot be visible if the wearer bends forward. Deeper cups are also preferable.


3.  Opt for deep side wings under the arms and no stiffeners to avoid rubbing or chafing on the scar tissue from lymph gland removal.


4.  Appropriate depth in the cup will accommodate the breast form.


5.  Pocketed bras are best for housing the breast.


6.  For optimum comfort, opt for bras with soft fabrics and seams.
    
7.  As advised by surgeons, we have found that wire free bras are, generally, better.


8. Multi-sectioned or pre-formed cups generally give a better and fuller shape.

After my mastectomy, I am not a candidate for breast reconstruction. What are my options?

Sometimes after a mastectomy, women experience swelling or lymphedema in the remaining breast tissue and are not candidates for breast reconstruction surgery.  Kristen demonstrates how a special breast prosthesis works with massaging technology to actually help remove fluid while you wear it! You can even insert it into your favorite pre-mastectomy bra.

Rita Wilson Has Breast Cancer, Undergoes Double Mastectomy and Reconstructive Surgery

BY ELIZABETH LEONARD
Photo Credit: Kristen Lara Getchell

Rita Wilson is sharing some difficult and very personal news: she was recently diagnosed with breast cancer and has undergone a double mastectomy and reconstructive surgery.

In an exclusive statement to PEOPLE, the actress, 58, reveals the diagnosis and how she feels "blessed" to have the love and support of her husband, Tom Hanks, friends, family and the doctors who saved her life.

"I have taken a leave from the play Fish in the Dark to deal with a personal health issue," reveals Wilson, who will return to the Broadway play on May 5. "Last week, with my husband by my side, and with the love and support of family and friends, I underwent a bilateral mastectomy and reconstruction for breast cancer after a diagnosis of invasive lobular carcinoma. I am recovering and most importantly, expected to make a full recovery. Why? Because I caught this early, have excellent doctors and because I got a second opinion.

"I have had an underlying condition of LCIS, (lobular carcinoma in situ) which has been vigilantly monitored through yearly mammograms and breast MRIs. Recently, after two surgical breast biopsies, PLCIS (pleomorphic carcinoma in situ) was discovered. I mention this because there is much unknown about PLCIS and it is often found alongside DCIS (ductal carcinoma in situ). I was relieved when the pathology showed no cancer.

"However, a friend who had had breast cancer suggested I get a second opinion on my pathology and my gut told me that was the thing to do. A different pathologist found invasive lobular carcinoma. His diagnosis of cancer was confirmed by, yet, another pathologist. I share this to educate others that a second opinion is critical to your health. You have nothing to lose if both opinions match up for the good, and everything to gain if something that was missed is found, which does happen. Early diagnosis is key.

"I feel blessed to have a loving, supportive husband, family, friends and doctors and that I am the beneficiary of advances in the field of breast cancer and reconstruction. I am getting better every day and look forward to renewed health.

"I hope this will encourage others to get a second opinion and to trust their instincts if something doesn't 'feel' right."

For more information, please go to the Breast Cancer Research Foundation website at BCRFcure.org.

Mastectomy vs. Lumpectomy for Early Breast Cancer: How to Choose

Weighing the pros and cons of two different surgical options.
By Deborah Kotz

Each year more than 200,000 women diagnosed with early-stage breast cancer, the most common kind, must make myriad treatment decisions. Among them: whether to have a mastectomy or breast-conserving surgery known as a lumpectomy.

If you’ve been diagnosed with a stage 1 or 2 breast tumor that’s not highly aggressive, you may have been offered both surgical options and left to decide which is best for you.

“Once we determine that we can remove the tumor with clear cancer-free margins, we generally leave the choice up to the woman whether to have a lumpectomy or mastectomy without recommending one over the other,” says Bonnie Sun, a breast surgeon at Sibley Memorial Hospital in the District of Columbia. “It becomes a personal decision, and the patient will have to decide, ‘what do I really want?’”

A large body of evidence indicates that breast cancer patients who have mastectomies face the same survival odds as those who have lumpectomies along with breast radiation, and for the past few decades oncologists have been encouraging women with early-stage breast cancer to opt for the less radical surgery.

In fact, an expert panel convened by the National Cancer Institute declared in 1990 that lumpectomy with radiation was “preferable” to mastectomy for women with stage 1 or 2 breast cancer – which helped drive down mastectomy rates for these patients from 100 percent in the 1980s to less than 40 percent today.

But the pendulum is starting to swing back a bit toward mastectomies. A 2014 study published in the journal JAMA Surgery – which examined anonymous records from 70 to 80 percent of American women who had breast cancer surgery – found that the percentage of those with early-stage breast cancer increased from 34 percent in 1998 to 38 percent in 2011.

While the study authors could not explain the reasons for the increase, several developments over the past decade may have contributed.

Improvements in breast reconstruction following mastectomy provide patients with more natural looking results than in decades past, says Mehra Golshan, director of breast surgical services at Dana-Farber Cancer Institute in Boston. More breast cancer patients are also getting insurance coverage for the procedure, thanks to a 1998 federal law mandating coverage.

In recent years, oncologists have moved away from strongly recommending lumpectomies toward involving women in a shared decision-making process, which entails a more in-depth discussion of the pros and cons of both surgeries.

Ask yourself the following questions to help determine which surgical option is best for you.

1. How much do you fear annual breast screenings and a potential new breast tumor? Many breast cancer patients opt to have a mastectomy – and even a prophylactic mastectomy on the other healthy breast – because they know they’ll feel extreme anxiety during future annual mammograms and over any abnormal finding, follow-up biopsy and possible diagnosis of another breast tumor down the road. About 5 percent of patients who opt for a lumpectomy will have a recurrence in the affected breast or opposite breast, Golshan says, but it’s rarely life threatening.

2. How much do you want to avoid a painful recuperation? Mastectomy with breast reconstruction typically involves multiple surgical procedures and a painful healing process that can last for weeks or even months. Lumpectomy, on the other hand, is usually a shorter procedure with a shorter recovery time but sometimes also requires a second surgery if a pathologist later finds cancer cells in the tissue surrounding the removed tumor.

 “I give patients the option of speaking with women who have had lumpectomies and mastectomies, so they can get first-hand experiences of what others went through,” Golshan says.

3. Do you have concerns about radiation treatments? After lumpectomy surgery, patients typically need five to seven weeks of radiation therapy, five days per week, to destroy any stray cancer cells. Side effects from the treatments can include breast swelling, fatigue and skin redness and blistering (like a sunburn). Scatter from the radiation can, in rare cases, damage the heart, lungs or surrounding bones.

Some women are now being offered a new option called intraoperative radiation therapy, IORT for short, in which a single dose of radiation is delivered directly into the tumor site during lumpectomy surgery. Those who have IORT do not need subsequent radiation treatments, but only certain patients are candidates. “These are women over age 45 with early-stage invasive tumors less than 2.5 centimeters in size,” says Andrea McKee, chairman of the radiation oncology department at Lahey Hospital and Medical Center in Burlington, Massachusetts. Candidates also must have only ductal breast cancer, which occurs in the milk-producing ducts, with no signs of tumor cells in healthy tissue surrounding the excised lump and no spread to local lymph nodes.

Some caveats: Since the procedure is fairly new, many cancer treatment centers do not yet offer it, and some insurance companies do not cover it. What’s more, about 15 percent of patients who have IORT wind up needing traditional radiation treatments because their final pathology report shows that they weren’t appropriate candidates, McKee says.

4. How much importance do you place on breast appearance? On sexual pleasure? Reconstructed breasts may look great, but they don’t respond to cold, heat, touch or stimulation, which can reduce sexual pleasure, Golshan says. Lumpectomy will retain the sensation of the breast, but may result in a lopsided appearance if a large amount of tissue is removed or if a woman has a small breast. For this reason, breast reconstruction may be offered along with lumpectomy to even out breast size.

5. What’s your life expectancy? Women diagnosed with breast cancer at a younger age may be more likely to opt for mastectomy because their longer expected lifespan means they have a higher lifetime risk of recurrence. “We typically tell patients that their risk of developing another primary breast cancer is about ½ percent per year,” Sun says. A 30-year-old breast cancer patient who expects to live another 50 years will face a 25 percent risk of developing another breast cancer compared to a 5 percent risk for a woman diagnosed at age 70.

Young breast cancer patients are also more likely to carry gene mutations that put them at even greater risk of recurrence, Sun said, which could tip the balance toward having a single or double mastectomy.

I've had a mastectomy. Can I still wear lingerie?

Even though you've had a mastectomy, you can still wear lingerie and feel sexy!  We carry a special line of lingerie made specifically for our mastectomy clients.  They come in all different sizes, colors and styles.  And even in matching sets!  Order yours in time for Valentine's Day!

Lymphedema Challenge

Actress and Academy Award winner, Kathy Bates recently kicked off theLymphatic Education & Research Network's Face of Lymphedema Challege. She proclaimed, "I'm Kathy Bates. I had a double mastectomy 2 years ago and as a result I have lymphedema in both arms. I didn't have a clue what would be involved after surgery and it was hard to find a doctor who would help me deal with, not only the physical effects, but the psychological effects as well. Struggling alone with lymphedema can feel like a punishment for having cancer. That's why I hope to bring awareness."

It's great to have such a high profile spokesperson help to bring awareness and hopefully a cure to lymphedema. Take the Face of Lymphedema Challege: http://lymphaticnetwork.org/get-involved/face-of-lymphedema-challenge/

Mothering through Breast Cancer: 5 Tips to Powerful Mothering Through Adversity

Sherrie Campbell, PhD

There is nothing more daunting to a woman who has children then to receive the diagnosis of breast cancer or any other type of serious illness. Our children are our worlds, and we are internally motivated and drawn to protect and raise them. They say there is nothing fiercer than a mama bear protecting her cubs, and when a diagnosis of cancer comes, many women feel deep fear and an unwavering will to live in an effort to continue raising her babies that makes her love her life and her children even more deeply and fiercely than ever before.

5 Tips to Mothering Through Adversity:

1. Provide Facts Only: Be completely open with your children about your diagnosis. It is important for children of all ages to have the facts about what is happening. Having all the information will actually make them less fearful and more prepared to help support you to fight. Give your children age-appropriate descriptions of what cancer is, how this may impact you physically and the ways you may feel emotionally. Allow them to ask questions and provide the space for them to share their fears and feelings. Facts eliminate more fears than does uncertainty. Facts help ground you and your children.

2. It is NOT their fault: Because children are ego-centric, they can take the diagnosis of your cancer and feel they somehow caused it to happen or that it is somehow or in some way their fault. For example, they may feel guilty for ever stressing you. It is important to reassure them, again and again, that your having breast cancer isn't anyone's fault, and that nothing they said or did, past or present, caused you to get breast cancer.

3. Cancer is not contagious: Cancer is scary to all people, but especially children. It can make all people unconsciously feel afraid of catching it, but especially younger children. It is important for both you and them that they understand their health is safe and that hugs, touching and kissing all will and need to continue to occur between you and them. Love is healing for you and them and this kind of touch is important especially in times of ill health.

4. Reassurance: It is hard for children to picture how their lives are going to work if you are really sick because as their mother, you have largely been their supplier of their schedule, lunches, social outings etc. Reassure them that, as a family, you all will work together to make sure everyone's needs are met easily and effortlessly. Extended family and friends will help as well. This gives children a sense of their security back, as they adjust to the diagnosis, that their needs and schedules will not be forgotten and things will remain in some state of normalcy.

5. Love is the answer: During stressful changes, love is what brings people through the most challenging and difficult traumas. Make sure your children know how loved they are and that the feelings of love you all have for each other can only grow from this experience. Because, as their mother, you are such an important stability in their lives, your love of them will help them the most during your healing, just as their love will help motivate you through your tough days.

Breast cancer coupled with being a mother is painful and scary for all involved. This is an incredible opportunity to model resilience and a positive mental attitude for your children. Everyone in their lives will face adversity, for some it is illness and others it may be something else traumatic, but your illness is a great opportunity to show your children how to dare greatly in the face of something scary, and this will also motivate you. It is an opportunity to show them that, at times in life, they will need to ask for help, they will feel scared and vulnerable, and they will have to sacrifice and stand tall with hard work in the face of fear.

Sherapy Advice: Breast cancer is your path back to strength, into strength and into feeling the deepest love for your life and children. Power on my beautiful women and mothers!

Dr. Sherrie Campbell is a veteran psychologist and the author of Loving Yourself: The Mastery of Being Your Own Person.

How to Wash a Mastectomy Prosthesis

Ever wonder what the best was is to wash a mastectomy prosthesis?  Watch our BOC/ABC certified mastectomy fitter demonstrate:

A Recent Review About Our Hair Loss, Lymphedema & Mastectomy Team!

"Do not miss the opportunity to visit Ricky Knowles Hair and Wellness. Ricky, Kristen and their team have been instrumental in making my journey a little less difficult. Ricky literally searched the world over to find the perfect human hair wig for me, then custom fit, cut and colored it to perfection so not even my family could tell it wasn't my own hair!

I volunteer at MD Anderson and the staff actually thought I was one of the few who did not lose hair in treatment. When I started going without the wig they wondered why I cut my hair so short - ha ha.

I developed mild lymphedema post radiation and it was challenging fitting me with a sleeve because I have such skinny arms and the edema only presented mid forearm. Kristen came to my rescue and we have tried different manufacturers to come up with just the right fit. I go to pick up my new "psychedelic" sleeve today:)

Last, but certainly not least, is Alex - the insurance miracle worker guru. Ricky was not in my network, but Alex contacted my insurance company and found out what I needed to do. After I did my part he went to work and filed all the necessary paper work. After review Aetna not only approved them but paid for my custom wig!!

Ricky Knowles Hair and Wellness has helped countless people with hair loss and lymphedema. I hear such positive stories many times over from patients I meet in the Breast Center at MDA. They truly make a difference in our lives that benefit us everyday."

-Rosemary

New Hair And Wellness Website!

We just launched out new website today! We're so proud of how it turned out and hope that you will find it full of good information about post-mastectomy products and services, hair loss and lymphedema solutions. The photos are of our real clients! We're so blessed that they agreed to pose as our models!
www.hairandwellness.com

What's Your Mammogram Risk?

BY DR. NANCY SNYDERMAN

A review of 50 years of studies of mammograms released Tuesday finds that the benefits have often been overstated and the harms minimized — adding to the confusion about what remains an annual ritual for many American women.

But do the benefits of a mammogram outweigh the risks for you or your family members? That's a very personal question, and not one with an easy answer.

Each patient has different risks that should be discussed with a doctor, but here are answers to some of the questions raised by the latest research.

We're seeing a lot in the news about this. What should I know about this particular study?

The study published Tuesday looks at 50 years' worth of international studies. It reminds us that mammograms are not perfect tests and that the benefits of the screening are often overestimated, while harms are underestimated.

According to the review, mammography screening is associated with a 19 percent overall reduction in deaths from breast cancer. This rate was not the same for all women, however. It reduced deaths by only 15 percent for women in their 40s and about 32 percent for women in their 60s. All of this underscores what we already know: This is not a perfect test and there is no hard and fast rule for mammograms that fits every woman.

What are the risks of mammograms? Isn't it better safe than sorry?

This study finds that for a 40- or 50-year-old woman who gets an annual mammogram, the risk of getting a false positive over 10 years is 61 percent. That means that 61 out of 100 women will have a false positive test. False positives don't just cause emotional distress — they often require repeat imaging and can also mean more invasive procedures like a biopsy.

I'm 40 and healthy. Should I get a mammogram?

What this study shows is that there is not a one-size-fits-all approach to breast cancer screening. What is appropriate for one woman is not always appropriate for her mother or her best friend. Decisions about whether to have a mammogram should be made with your doctor and based on your individual risk for cancer.

Women with a higher risk of breast cancer based on family history or individual risk factors will benefit more from mammography than women of lower risk. Factors to consider include age, a history of cancer, genetic risk factors like the BRCA1 and BRCA2 genes, use of certain medications like some hormone replacement, increased alcohol use, obesity and not having a child before age 30.

We're seeing studies talking about the risk of mammograms. Why are doctors still using them?

Breast cancer kills 40,000 American women per year. At this point, mammograms are the best screening tool that we have. They aren't perfect, but used correctly, they can be lifesaving. However, doctors and researchers are working to develop better tools and one day these might replace mammograms.

Should I do breast self-exams?

While an awareness of your body is always a good idea, the evidence does not show that self-exam does a good job of detecting breast cancer. The U.S. Preventive Services Task Force recommends against teaching breast self-examination.

What age should women stop getting mammograms?

There is not enough evidence to recommend for or against mammograms after age 75, according to the task force. Another study published Tuesday suggests that this decision should be based on your life expectancy. For example, if your life expectancy is less than 10 years due to an illness, mammograms might not be the best choice. Again, it's an individual decision and should involve a thoughtful conversation and consideration of your unique medical profile.

Starting Chemotherapy: Nutrition Tips

If you are undergoing chemotherapy, you want to stay as healthy and comfortable as possible during treatment. What you eat during treatment can make a big difference in helping you achieve that goal.

Keep Food Tasty. Chemo can do a number on your taste buds, making certain foods and drinks taste metallic or unpleasant. Water and meat are the two most common items that become distasteful during chemo. If it becomes difficult to drink plain water, try drinking flavored mineral water or add sliced lemon to tap water. If certain meats become difficult to enjoy, try other sources of protein such as eggs, low-fat dairy, beans, and fish.

Fight Constipation. While some people experience diarrhea with chemo, others deal with constipation. Keeping hydrated is important to help prevent constipation. Including all types of fiber in your diet also can be helpful. If you aren't accustomed to large amounts of fiber, make sure to increase your fiber slowly. Getting some exercise -- even just a 20-minute walk -- can be a powerful intestinal stimulant.

Manage Weight Gain. Some cancer patients tend to gain weight during treatment.  Stick to low-fat meals, snacks, and lots of vegetables.

Improve Your Appetite. Many people undergoing chemo find that their appetites suffer. Since carbohydrates are usually digested well, try snacks such as hot cereals, toast with peanut butter or other nut butter, or pita bread with hummus. Other foods to consider include yogurt and blended soups.

Ease Diarrhea. If you are experiencing diarrhea, avoid greasy and fried foods, caffeine, sugary drinks and fruit juices, salad greens, raw produce, and sugar alcohols. Foods that are generally well-tolerated include oatmeal, most fruits without skin, sweet potatoes, and squash.

Keep a Food and Symptom Diary. Write down what you eat and drink, and record any symptoms you experience daily. This will help you and your health care team identify what you are eating that may be causing nausea, constipation, or diarrhea. This way, medications and other dietary suggestions can be tried before problems escalate.

Best Weight Loss Apps of 2014!

Year after year, weight loss reigns as one of the most popular New Year's resolutions. Yet obesity remains an epidemic in the United States. Whether you want to lose 5 pounds or 50, stick with it in 2014, so that next year your goal is just to keep the weight off. With countless apps and wearable tech designed to help you meet your fitness goals, there are no excuses this year. Eat well, work out, and stay motivated with the help of this technology.

Lose It!
www.loseit.com

Lose It! has been one of the most popular health apps on iTunes for several years now. The easy-to-use app makes it easy to keep track of weight loss goals. Enter your current weight and your desired weight and the app will tell you the maximum daily calories you can consume to meet your goal. Log fitness activities and scan barcodes on food items, to easily keep track of your progress. Weigh yourself every day and see a line graph of your progress. This free app is available on iOS and Android, with additional charges for upgrades.


Daily Workouts
www.dailyworkoutapps.com

Save money on a gym membership this year. Work out at home! The Daily Workout app is essentially a workout video for your smartphone or tablet, broken up into five or ten minute routines. This app will get your butt, arms, abs and legs in shape, while saving you a time. The workouts are as effective as your local fitness class. This free app is available on iOS and Android, with additional charges for upgrades.

Jawbone UP
www.jawbone.com

"Wearable tech," was definitely a catchphrase of 2013 and that's expected to continue into the new year. With fitness-tracking wristbands gaining popularity, there's no sign that the momentum is slowing down. The Jawbone UP band is one of the more popular devices and recently came out with a new version, called the UP24. In addition to tracking steps taken and calories burned, the water-resistant band keeps tab on sleep patterns via its smartphone app. Set an alarm to wake you up in your lightest sleep phase, and the band promises you'll be refreshed. Add friends to your "team," and tell them to step it up! The Jawbone UP24 retails for $149.99


Fitbit
www.fitbit.com/iphone

The Fitbit is another contender for the hottest in wearable tech. The recently released Fitbit Force, is an upgrade to the Flex. Like the Jawbone UP, the Fitbit bands track steps taken and hours slept. Yet unlike the previous Fitbit, the Force displays real-time data on the band's screen, doubling as a watch. Sync with the app to track progress and compete with your friends. The Fitbit Force retails for $129.95


ShopWell
www.shopwell.com/home/mobile

In an era where people track everything from carbs to gluten, ShopWell helps you keep track of all your dietary needs. Next time you're at the grocery store, scan barcodes of food items and ShopWell will tell you if the product meets your requirements. If not, it will suggest another similar product that does. Whether you're looking to lose weight, avoid allergies, or help with diabetes, ShopWell will do you well. This free app is available on iOS and Android.

Preventative Mastectomy is an Option for Women Who are at a Very High Risk

From the Meadville Tribune

People around the world were shocked to learn that actress and activist Angelina Jolie opted to have a double mastectomy in 2013 to reduce her risk of breast cancer. Jolie, who was 37 years old at the time of the procedure, reportedly learned that she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer. In addition, the actress has a family history of cancer. Her mother, Marcheline Bertrand, died of ovarian cancer in 2007 at the age of 56.

By having a preventive mastectomy, Jolie reduced her breast cancer risk from 87 percent to 5 percent, according to an op-ed piece she authored in The New York Times. Jolie is not the only well-known actress to opt for a preventive mastectomy, as fellow thespian Christina Applegate had a similar procedure in 2008 after learning she had a mutation of the BRCA1 gene. These highly publicized cases have left many women wondering if a preventive mastectomy is something they should consider.

BRCA stands for "breast cancer susceptibility genes," a class of genes known as tumor suppressors, says the National Cancer Institute. Mutations in these genes have been linked to hereditary breast and ovarian cancer. A person's risk of developing breast and/or ovarian cancer is greatly increased if he or she inherits a harmful mutation in BRCA1 or BRCA2. Mutations in these genes could also put a person at increased risk for other cancers.

Genetic tests can check for mutations in BRCAgenes. During such a test, a blood sample is taken, and if a mutation is found, a person may get genetic counseling and work with a doctor to develop a plan of action. It is important to note that not all people with a genetic mutation will get breast cancer or ovarian cancer. The National Cancer Institute's "SEER Cancer Statistic Review" states a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.

Although there is no surefire way to determine if a person with a mutated gene will develop breast cancer, many women who are considered high risk opt for a preventive mastectomy to reduce their risk. Women who have a family history of breast cancer, have received positive results from gene testing, have already had cancer in one breast, or have dense breasts that make testing difficult may want to get a preventive mastectomy.

The decision to get a preventive mastectomy is not one to take lightly. Many breast centers are staffed with breast-health specialists, genetic counselors, breast surgeons, and reconstructive surgeons who can help patients make the best decision. Second opinions are strongly recommended for women considering a preventive mastectomy.

Women should understand the options available to them if they have an extremely elevated risk of breast cancer or ovarian cancer.

Early Detection & Breast Health Tips

1. Early Breast Cancer Detection – Experts recommend women get to know their own bodies: report any changes in your breast to your medical provider right away and talk to your doctor about your risk of breast cancer and when to be screened. Medical experts also recommend:

• Women age 40 and older should have a mammogram every year 
• Women in their 20s and 30s should have a clinical breast exam (CBE) as part of their periodic health exam by a health professional, preferably every three years 
• Breast self exam: Experts now recommend that women get to know their own bodies and watch for any changes. BSE is an option for women starting in their 20s. You should report any changes in your breast health to your doctor right away. 

2. Reduce Your Risk – Here are some suggestions to help reduce your risk of breast cancer:

• Examine your family history – Your risk is increased if a family member has had breast cancer, especially if a first-degree relative (mother, sister, daughter) is diagnosed before the age of 50. Speak with a nurse, doctor or your medical provider about your breast cancer risk and additional steps you can take to reduce your risk. 
• Get some exercise– Brisk walking for one hour a day can your reduce risk by more than 15%. The American Cancer Society recommends you engage in at least 45 minutes of physical activity at least 5 days a week. 
• Minimize radiation exposure – The human breast is sensitive to radiation, especially if exposure occurs at young ages. Girls repeatedly exposed to radiation before the age of 20 are at highest risk for developing breast cancer later in life. 
• Modify alcohol intake – Regular consumption of one drink a day for women is associated with an increased risk of breast cancer. 
• Avoid smoking and secondhand smoke – Tobacco smoke is a known human carcinogen and is an established risk factor for lung cancer. Exposure to smoking and secondhand smoke should be avoided, particularly during childhood, puberty, pregnancy and when breast feeding. 
• Avoid exposures to exogenous estrogens 
• Hormone replacement therapy – Use only if absolutely necessary; use for as short a time as possible, and discuss alternatives with your doctor. 
• Hormonally active environmental chemicals – Some studies suggest chemicals in our homes, water and environment may play a role in cancer development. 
• Maintain leanness or reduce weight – The relationship between being overweight and breast cancer risk is one of the best understood to date. It is known that women who gain more than 20 pounds from age 18 to midlife double their risk of breast cancer (postmenopausal) compared to women whose weight remains stable. 

3. Lymphedema – Lymphedema is a chronic, debilitating disorder following cancer treatment that can cause arm swelling and chronic inflammation. There are new advances and recommendations for women diagnosed with breast cancer:

• Newly diagnosed women should ask their doctor for a perometry screen or BIS (bioimpedance spectroscopy) screen before they have breast cancer surgery and at regular follow-up visits. Survivors who have already undergone surgery should ask their doctor if BIS or perometry might be helpful in their ongoing care. 
• Exercise and weight training have been shown to help reduce the risk of lymphedema and to reduce the severity of the disorder in already affected patients. Women should discuss exercise and weight-lifting regimens with their doctor or a well-trained or certified lymphedema therapist. 

4. Nutrition – Nutrition plays an important role in your health.

5. Know Your Resources –Don't overlook your own breast health. Survival rates increase dramatically in women who've been diagnosed with breast cancer early. If you are living in a low-income household, or are underinsured or uninsured, there are many resources available, regardless of your ability to pay, that can help you seek out the proper breast care:

• The Centers for Disease Control (CDC) offers an online search tool for women to seek out free and low-cost screenings across the country. 
• For information on breast cancer and tools to help you seek out medical care, visit the American Cancer Society's website at www.cancer.org/Cancer/BreastCancer/index

I Am Scheduled To Undergo Mastectomy Surgery. What Are Some Recovery Tips?

Going through mastectomy surgery can be extremely taxing on both your body and your emotions.  Here are some tips to help you when you get home.

Follow Your Doctors Instructions
Follow all your Doctor’s instructions in regards to wound care, rest, lifting restrictions, driving, surgical bras and garments etc.  Most importantly if your Doctor says don’t do something – listen and don’t do it!

When discharged from hospital ask all your questions (to Doctors and Nurses) no matter how insignificant you may think they are and have contact numbers for when you get home and have another question or concern.

Rest, Rest and then Rest Some More
Take it totally easy the first full week.  Take multiple naps, watch movies, read books and relax.  Have people do almost everything for you to avoid overdoing it.  Be warned it is super easy to overdo it when you first get home.  Even opening the fridge, opening drawers, picking up stuff and carrying laundry is too much!  Also washing your hair is too much in the first week as you can’t lift your arms so book into the hairdressers.  If you do too much you will pay for it that night and the next day with muscle pain and a very sore body.

Fatigue is normal.  Gradually increase your activity and ease back into your ‘normal’ routine.  Remember most women require four to six weeks off work to recover.  A mastectomy is a major invasive surgery and body tissues need rest to recover and repair from the procedure.  By over doing it you are slowing down your recovery and healing.

Remember no strenuous activity or lifting for approximately six weeks following your surgery (your Doctor will tell you when you are ready).

Medication and Pain Control
Get all your scripts filled immediately (with non child proof caps – you will find the push down and turn type difficult to open with limited arm strength) and in a notebook write down what you take and when.  It is easy to lose track of whether you have taken your medication or not and writing it down ensures you have and have taken it at the right time (and haven’t taken a double dose).  Writing down your pain medication is also useful as it allows you to slowly reduce the amount and strength over a few weeks.   

When it comes to pain management take your pain medication regularly.  The job of the medicine is to avoid pain.  If you get in too much pain you will feel miserable waiting for the pain medication to kick in.  Also studies have shown that a patient who has less pain recovers better.

Medical Supplies
It is useful to have the following at home:

• Laxatives as the pain medications/general aesthetic can make you constipated
• Ibuprofen
• Acetaminophen
• Post scar treatment (although you won’t need this until your tape/bandages have been removed)
• Spare dressings (although in some cases you won’t need these as your Surgeon will remove your tape/dressings at your first follow up appointment)

Sleeping
You will most likely need to sleep on your back for at least three or four weeks (definitely the case if you have had a double mastectomy).  This is actually harder than it sounds if you are used to sleeping on your stomach or side and getting sleep is really important for your recovery (and feeling rested and able to cope in general).

Exercise
Follow your Surgeon’s instructions regarding exercise.  Usually you will be encouraged to walk and have been doing laps of the hospital.  When you get home walk a bit further each day.  Listen to your body and stop if you get tired or dizzy.  Resume more physically active exercise, running, swimming etc. once your Doctor gives approval and gradually build back up to your pre surgery levels.

It can be frustrating, for example if you were a runner and feel great but still have bruising and swelling and your Surgeon says no running (raising your heart rate/pulse slows down healing) – listen, grit your teeth and DON’T RUN.

Get Comfortable
New clothes may be necessary to accommodate your surgery.  Specialty camisoles are a great option because they provide a light layer that can hold drains.  Many styles have pockets to hold forms and can be worn under your clothing.  You may also opt for a robe that is made with pockets for breast forms or ice packs and also can support the weight of fluid from drains.

You will want to get a prosthesis or breast form around six weeks after surgery.  Typically at this time the swelling will have reduced.  Make sure that you see a BOC or ABC certified fitter.  These certifications ensure that you are fitted properly.  A certified fitter can also help you find a well-fitting bra to act as a good foundation for style and comfort.

Drink Water
It is very important that you drink plenty of water during your mastectomy recovery.  While having surgery, a lot of blood and other fluids are removed from the body and you will have to reinstate these in the days following surgery for getting the best recovery results.

Eat Well
To assist your recovery each a diet rich in nutrients – in other words eat healthy.  For your cells and tissues nutrients are the building blocks and will assist your recovery.  So eat a well balanced diet of to help your body.

Support and Talking to Others
Regardless of your level of support from family and friends, you may find it helpful to talk to others who have gone through a mastectomy.  Talking to others who have gone through the same decision making process and procedure will give first hand understanding and support.  It is a major deal both physically and emotionally to undergo a mastectomy and it helps to connect with other women who have gone through what you are feeling.

You have just come home from major surgery and most likely haven’t finished your reconstruction so be aware that your chest/breasts/body will not look perfect/normal and you still have recovery and further surgery to go – however you have just achieved something amazing so try to be proud of your body.

Our team at Ricky Knowles Hair and Wellness is here to support you through your journey.  We can connect you with a support group that fits with your schedule, fit you for a mastectomy prosthesis, help you with with lymphedema preventative care, and serve as your patient advocate by untangling the insurance benefit web.  We have a BOC, ABC mastectomy prosthesis fitter and an insurance specialist on staff.   In addition to mastectomy forms, we also carry post mastectomy products such as camisoles, bras and robes.  If you are ready for us to partner with you, please call us at 713-623-4247.